From the Guidelines
The conception rates after salpingectomy vary significantly depending on the extent and type of procedure performed, with complete bilateral salpingectomy resulting in a 0% natural conception rate, while unilateral and partial salpingectomies may allow for conception rates ranging from 25-80%. For complete bilateral salpingectomy, natural conception is impossible (0%) as both fallopian tubes are entirely removed, eliminating the pathway for egg and sperm to meet 1. With unilateral salpingectomy (removal of one tube), natural conception rates range from 25-70%, as one functional tube remains to facilitate fertilization. Partial salpingectomy may allow conception rates of 40-80% depending on how much tube remains functional. The location of the salpingectomy also matters; distal (far from uterus) procedures have better outcomes than proximal ones.
Some key points to consider in the context of conception after salpingectomy include:
- The extent of the salpingectomy: Complete removal of both tubes eliminates natural conception possibilities.
- The remaining tubal function: The amount of healthy tube left after surgery can significantly impact conception rates.
- The woman's age: Age is a critical factor in fertility, with younger women generally having higher conception rates.
- Ovarian reserve: The health and function of the ovaries play a crucial role in fertility.
- Partner's fertility factors: The fertility potential of the partner can also influence overall conception rates.
For women who have undergone bilateral salpingectomy and wish to conceive, in vitro fertilization (IVF) is necessary, with success rates comparable to women with tubal factor infertility (approximately 30-45% per cycle depending on age and other factors) 1. The conception potential after salpingectomy depends on these factors, and women considering pregnancy after salpingectomy should consult with a reproductive endocrinologist to discuss their specific situation and options.
From the Research
Salpingectomy and Conception Rates
The relationship between the level of salpingectomy and conception rates is a topic of interest in the field of reproductive medicine. Several studies have investigated this relationship, with varying results.
- A study published in the Journal of Minimally Invasive Gynecology in 2017 found that patients undergoing IVF after salpingectomy for an ectopic pregnancy had a statistically significantly longer duration of stimulation and required higher gonadotropin doses compared with patients undergoing IVF after salpingectomy for other indications 2.
- However, another study published in the International Journal of Surgery in 2017 found that childbearing rates were significantly higher in the salpingectomy group compared to the salpingotomy group, although there was no significant difference in fertility outcomes between the two groups 3.
- A study published in Fertility and Sterility in 2001 compared ovarian response and IVF-ET cycle outcome in patients with hydrosalpinges managed by either laparoscopic salpingectomy or proximal tubal occlusion, and found that clinical pregnancy and implantation rates were not significantly different between the two groups 4.
- More recent research published in the Revista Brasileira de Ginecologia e Obstetricia in 2021 suggests that salpingectomy may improve implantation rates in IVF by restoring the endometrial expression of HOXA10, a gene that plays an essential role in directing embryonic development and implantation 5.
- An earlier study published in Human Reproduction in 1994 found that bilateral salpingectomy did not compromise ovarian stimulation in an in-vitro fertilization/embryo transfer programme, and that implantation ratio, pregnancy rate, and outcome were the same as in a control group of women with healthy Fallopian tubes 6.
Percentage of Conception with Level of Salpingectomy
While the exact percentage of conception with level of salpingectomy is not explicitly stated in the studies, the available evidence suggests that:
- Salpingectomy for ectopic pregnancy may result in a longer duration of stimulation and higher gonadotropin doses, but does not significantly affect implantation and clinical pregnancy rates 2.
- Salpingectomy for hydrosalpinges may improve implantation rates in IVF, although the exact percentage of conception is not specified 5.
- Bilateral salpingectomy does not appear to compromise ovarian stimulation or implantation rates in IVF, with pregnancy rates and outcomes similar to those in women with healthy Fallopian tubes 6.